Patients with chronic low back pain and other chronic overlapping pain conditions, compared with patients with low back pain alone, experienced more severe pain symptoms and higher levels of anxiety, depression, and fatigue, according to an analysis from the OPTIMUM trial.
The report was published in the October issue of the European Journal of Pain.
Chronic low back pain is one of 10 chronic overlapping pain conditions that are theorized to share the same underlying mechanism of pathophysiology. Little is known about the prevalence and co-occurrence of these conditions.
The other chronic overlapping pain conditions include migraine, chronic tension-type headache, fibromyalgia, irritable bowel syndrome, myalgic encephalomyelitis/chronic fatigue syndrome, temporomandibular disorders, urological chronic pelvic pain syndrome/painful bladder syndrome, endometriosis, and vulvodynia.
Among 285 participants in the OPTIMUM trial, 45% had one chronic overlapping pain condition and 24% had 2 or more of the conditions, in addition to chronic low back pain. The most common conditions were irritable bowel syndrome, myalgia encephalomyelitis/chronic fatigue syndrome, and fibromyalgia. Patients with overlapping pain conditions had worse scores on measures of physical functioning and pain symptoms.
“Given the financial, symptomatic, and frustrating burden of [chronic overlapping pain conditions], it is important that researchers explore these conditions in more detail and seek treatments which address symptoms that patients report as the most detrimental to everyday functioning,” the authors concluded.
OPTIMUM, an NIH Collaboratory Trial led by Natalia Morone of Boston University and Boston Medical Center, is studying the addition of mindfulness-based stress reduction to usual care for patients with chronic low back pain, with the goal of improving pain outcomes and reducing opioid prescriptions. The study is supported within the NIH Pragmatic Trials Collaboratory through the NIH HEAL Initiative by a grant award administered by the National Center for Complementary and Integrative Health. Learn more about OPTIMUM.